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Tuesday, January 29th, 2013
Imagine a Blackhawk helicopter landing on campus carrying badly wounded troops from the battlefield. Student doctors rush the injured warriors into a makeshift emergency room and begin lifesaving procedures.
At the Rocky Vista University College of Osteopathic Medicine (RVUCOM) in Parker, Colo., students in the military medicine track take part in such mock scenarios, thanks to Cut Suit technology: human-worn surgical simulators that can replicate all manner of wounds, hemorrhages, airway complications and intense bleeding. The suits have breakable and repairable skin, bones and internal organs, allowing students to engage in realistic resections, suturing and other procedures.
With two on loan from the manufacturer, RVUCOM is the only medical school in the country to use Cut Suits in training students, says Bruce D. Dubin, DO, JD, RVUCOM’s dean.
Since Dr. Dubin launched the school’s military medicine track three years ago, RVUCOM has established a reputation as a training ground for students interested in serving in the Medical Corps of the U.S. Army, Navy and Air Force.
Ninety-five students on military scholarships attend RVUCOM. The school has more students with Armed Forces Health Professions (AFHP) scholarships than any other osteopathic medical school or any MD school save for the Uniformed Services University of the Health Sciences in Bethesda, Md., according to Dr. Dubin.
“Rocky Vista is in a great location for attracting people interested in military careers because Fort Carson, Peterson Air Force Base and the U.S. Air Force Academy are in Colorado,” he says.
Besides their Cut Suit training, students on AFHP scholarships practice battlefield trauma procedures on a dedicated cadaver and receive didactic instruction in combat medicine. In addition, guest speakers from the military come to campus to conduct training exercises, discuss life on the front lines, and describe Army, Navy and Air Force residency programs and career opportunities.
Evolving from Hollywood special-effects technology, the Cut Suit was developed in collaboration with the military to improve training in tactical combat casualty care.
Retired Army colonel Anthony LaPorta, MD, the course director of RVUCOM’s military medicine track, spearheaded the school’s adoption of the wearable simulators just over a year ago, when they became declassified. A general surgeon involved in military surgical education for 26 years, Dr. LaPorta has since become a leading champion of Cut Suit technology.
Because of the portability of the 30-pound suits, Dr. LaPorta can take them to military training sites. Recently he brought several second-year RVUCOM students to Fort Carson, where he trained them alongside U.S. Army Special Forces, including medics, in battlefield procedures. “The special ops like being able to train in scenarios with real human stress, provided by the actors who wear the Cut Suits,” he says.
Dr. LaPorta is helping to research improvements in the Cut Suit, providing feedback to the manufacturer on how to refine the simulation of various organ systems. Currently, some parts and processes are more sophisticated than others.
For example, the suit simulates limb amputations effectively, with profuse fake bleeding controlled by a pump. “The correct application of a tourniquet will stop the bleeding,” he says. “But I also want a real-feeling mesentery. I want students to have the experience that if they tie a knot in this tissue correctly, the bleeding will stop and if they don’t, the bleeding will continue.”
Dr. LaPorta and the Cut Suit manufacturer are working with the University of Minnesota’s Center for Research in Education and Simulation Technologies, which has an extensive database of human tissue properties used to develop accurate simulation models. The first project in this collaboration will be a realistic model of a mesentery with arcaded blood supply to a segment of the small intestine.
As it is, the Cut Suit is a great training tool for a number of procedures, according to Dr. LaPorta. “Using the suit, you can do a cricothyrotomy, a needle decompression of a tension pneumothorax, and a full tube insertion,” he says. “You can open the chest completely and control bleeding and take out a lung. You can open the abdomen completely and control bleeding and do a partial liver resection.”
As the technology improves, RVUCOM will use the suits in nonmilitary classes.
A biomedical engineer who was in the Army Reserves for 12 years before attending RVUCOM, Genevieve R. Mueller, OMS III, has acquired enough experience using Cut Suits that she helps Dr. LaPorta as a training assistant, sometimes wearing one of the suits. “Because of a protective metal plate, the actor wearing a Cut Suit just feels a little overall pressure,” she says. “It is very warm in there, however.”
Mueller points out that she and her classmates were lucky to have been able to use the suits in their second year of med school. Although operating on a cadaver gives students a better view of human anatomy, performing procedures on a Cut Suit has several advantages, she says.
“When cadavers are chemically treated, the tissue properties change. Although a Cut Suit isn’t exactly like human tissue, it feels more lifelike than cadaver tissue does,” Mueller says. In addition, the suits simulate real surgical sounds and odors.
“The Cut Suit has controlled vascularity, so that if you’re cutting into the abdomen and nick the bowel, it will start to bleed and even smell like a bowel,” says Mueller. “And because someone wears the Cut Suit, the overall experience is much more real for students.”
Mueller, who plans to become an emergency physician, has already scheduled her fourth-year audition rotations at Army hospitals. The military match takes place in mid-December.
In December 2012, 23 fourth-years at RVUCOM took part in the military match. Eight students matched into Army residency programs, nine into Navy residencies and five into Air Force programs.
“Our military medicine training at Rocky Vista prepares us well for the challenges of residency and combat care,” Mueller says.